Examples of using Pitolisant in English and their translations into German
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The active substance is pitolisant.
Pitolisant is contra-indicated in patients with severe hepatic impairment(Child-Pugh C) see section 4.3.
Wakix contains the active substance pitolisant.
Medicinal products that pitolisant may affect metabolism.
Wakix contains the active ingredient pitolisant.
The active substance in Wakix, pitolisant, works by attaching to receptors in the brain called‘histamine H3 receptors.
Medicinal products affecting pitolisant metabolism.
Pitolisant should be administered with caution in patients with severe obesity or severe anorexia see section 4.8.
In 68 to 80 years old patients the pharmacokinetics of pitolisant is not different compared to younger patients 18 to 45 years of age.
Pitolisant pharmacokinetics after repeated administration in patients with hepatic impairment has not been evaluated yet.
Patients with abnormal levels of sleepiness who take pitolisant should be advised that their level of wakefulness may not return to normal.
Pitolisant is not a significant inhibitor of OAT1, OAT3, OCT2, OATP1B1, OATP1B3, MATE1, or MATE2K at the tested concentration.
Cataplexy attacks frequency in patientsdisplaying this symptom was decreased significantly(p=0.034) with pitolisant(-65%) compared to placebo -10.
Pitolisant blocked hERG channel with an IC50 exceeding therapeutic concentrations and induced a slight QTc prolongation in dogs.
Harmony CTP, a supportive double blind, randomized, parallel group study of pitolisant versus placebo, was designed to establish pitolisant efficacy in patients with high frequency cataplexy in narcolepsy.
Pitolisant exhibits high serum protein binding(> 90%) and demonstrates approximately equal distribution between red blood cells and plasma.
Several conjugated metabolites were identified, the major ones(inactive) being a glycine conjugate of the acid metabolite of O-dealkylated desaturated pitolisant and a glucuronide of a ketone metabolite of monohydroxy desaturated pitolisant.
Based on in vitro data, pitolisant and its main metabolites may induce CYP3A4 and CYP2B6 at therapeutic concentrations and by extrapolation, CYP2C, UGTs and P-gp.
Nevertheless, patients with cardiac disease, co-medicated with other QT-prolonging medicinal products or known to increase the risk of repolarization disorders,or co-medicated with medicinal products that significantly increase pitolisant Cmax and AUC ratio(see section 4.5) or patients with severe renal or moderate hepatic impairment(see section 4.4) should be carefully monitored see section 4.5.
The effect size of pitolisant compared with placebo based on a model for WRC based on BOCF with centre as a fixed effect was 0.581, 95%CI[0.493 to 0.686]; p< 0.0001.
Pitolisant shows greater than 50% inhibition towards OCT1(organic cation transporters 1) at 1.33 µM, the extrapolated IC50 of pitolisant is 0.795 µM see section 4.5.
Juvenile toxicity studies in rats revealed that the administration of pitolisant at high doses induced a dose related mortality and convulsive episode that may be attributable to a metabolite abundant in rats but not in humans.
The exposure to pitolisant in healthy volunteers was assessed in studies involving more than 200 subjects that received doses of pitolisant in single administration up to 216 mg and for a duration up to 28 days.
Patients with excessive daytime sleepiness, including those taking pitolisant should be frequently reassessed for their degree of sleepiness and, if appropriate, advised to avoid driving or any other potentially dangerous activity.
The results with pitolisant were significantly superior to those in the placebo group(mean difference: -3.33; 95%CI[-5.83 to -0.83]; p< 0.05) but did not differ significantly from the results in the modafinil group mean difference: 0.12; 95%CI -2.5 to 2.7.
In narcoleptic patients with or without cataplexy, pitolisant improves the level and duration of wakefulness and daytime alertness assessed by objective measures of ability to sustain wakefulness e. g.
The observed WRC in pitolisant group was about half of WRC in the placebo group: the effect size of pitolisant compared with placebo was summarized by the ratio rate rR(Pt/Pb), rR=0.512; 95%CI[0.435 to 0.603]; p< 0.0001.
Gastric disorders reactions have been reported with pitolisant, therefore it should be administered with caution in patients with acid related gastric disorders(see section 4.8) or when co-administered with gastric irritants such as corticosteroids or NSAID.
The effectiveness of pitolisant up to 36 mg once a day, for the treatment of narcolepsy with or without cataplexy was established in two main, 8 weeks, multicenter, randomized, double-blind, placebo-controlled, parallel group trials Harmony I and Harmony CTP.
The following adverse reactions have been reported with pitolisant during clinical studies enrolling more than 1094 patients in narcolepsy and other indications and are listed below as MedDRA preferred term by system organ class and frequency; frequencies are defined as: very common(≥1/10), common(≥1/100 to< 1/10), uncommon(≥ 1/1,000 to< 1/100), rare(≥1/10,000 to< 1/1,000), very rare(< 1/10,000); within each frequency group, adverse reactions are presented in order of decreasing seriousness.